technetium-tc-99m-sulfur-colloid and Anaphylaxis

Topics: Anaphylaxis; Humans; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid

Topics: Anaphylaxis; Breast Neoplasms; Coloring Agents; Female; Humans; Mastectomy, Segmental; Middle Aged; Neoplasm Staging; Postoperative Complications; Risk Factors; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

Topics: Anaphylaxis; Breast Neoplasms; Female; Humans; Radiopharmaceuticals; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

After being diagnosed with a melanoma, an 18-year-old woman developed anaphylactic shock following an intracutaneous injection of patent blue during a sentinel lymph node biopsy procedure. Intracutaneous allergy tests revealed positive reactions with patent blue (Bleu patenté V 'Guerbet') as well as with several anaesthetics and morphine. It was concluded that patent blue was the most probable causative agent for the anaphylactic reaction and that the possibility of such a reaction should be taken into consideration during sentinel node procedures. After a few days the operation was completed under epidural anaesthesia with technetium Tc 99m sulphur colloid being used to detect the sentinel node.

Topics: Adolescent; Anaphylaxis; Coloring Agents; Contrast Media; Female; Humans; Injections; Injections, Intradermal; Lymph Nodes; Melanoma; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Skin Neoplasms; Technetium Tc 99m Sulfur Colloid

Sentinel lymph node biopsy (SLNB) is an alternative to axillary dissection for many breast cancer patients. Cases of anaphylactic reaction to the isosulfan blue dye used during SLNB have recently been reported. No study on the incidence of serious anaphylactic reactions during SLNB for breast cancer has been reported.. We reviewed 639 consecutive SLNBs for breast cancer performed at our institution. Sentinel lymph node biopsy was performed using both isosulfan blue dye and technetium-99m sulfur colloid. Cases of anaphylaxis were reviewed in detail.. Overall, 1.1% of patients had severe anaphylactic reactions to isosulfan blue requiring vigorous resuscitation. No deaths or permanent disability occurred. In patients with anaphylaxis, hospital stay was prolonged by a mean of 1.6 days. In 1 patient, the anaphylactic reaction required termination of the operation.. Prompt recognition and aggressive treatment of anaphylactic reactions to isosulfan blue are critical to prevent an adverse outcome. Lymphatic mapping with blue dye should be performed in a setting where personnel are trained to recognize and treat anaphylaxis.

Topics: Aged; Anaphylaxis; Breast Neoplasms; Humans; Middle Aged; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid